Neuromuscular Fatigue After Long-Duration Adventure Racing in Adolescent Athletes

PURPOSE

To characterize the acute effects of a long-duration adventure race on knee extensor (KE) fatigue and the knee functional ratio in adolescent athletes.

METHODS

Twenty trained male adolescents (aged 14-17 y) performed an adventure race of 68.5 km. Maximal voluntary isometric contraction (MVIC) KE and knee flexor torques were measured before and immediately after the race. Central and peripheral components of neuromuscular fatigue were quantified from the maximal voluntary activation level and the doublet peak torque (Tw100), respectively. The peak eccentric knee flexor torque to concentric KE torque ratio was also measured to determine functional ratio.

RESULTS

The race completion time was 05:38 (00:20) hours. Significant reductions in MVICKE (-14.7%, P < .001) and MVICKF (-17.0%, P < .01) were observed after the race. Voluntary activation level decreased by 8.3% (P < .001) while Tw100 remained unchanged. Peak eccentric knee flexor torque decreased 16.0% (P < .001) while peak concentric KE torque did not change. This resulted in a significant reduction in functional ratio (-12.0%, P < .01).

CONCLUSION

The adventure race induced a moderate fatigue, which was mainly explained by central factors without significant peripheral fatigue. However, particular attention should be paid to the knee muscular imbalance incurred by the race, which could increase the risk of ligament injury in adolescent athletes.

Exercise-induced fatigue in young people: advances and future perspectives

PURPOSE

In recent decades, the interest for exercise-induced fatigue in youth has substantially increased, and the effects of growth on the peripheral (muscular) and central (neural) mechanisms underpinning differences in neuromuscular fatigue between healthy children and adults have been described more extensively. The purpose of this review is to retrieve, report, and analyse the findings of studies comparing neuromuscular fatigue between children and adults. Objective measures of the evaluation of the physiological mechanisms are discussed.

METHOD

Major databases (PubMed, Ovid, Scopus and Web of Science) were systematically searched and limited to English language from inception to September 2017.

RESULT

Collectively, the analyzed studies indicate that children experience less muscular and potentially more neural fatigue than adults. However, there are still many unknown aspects of fatigue regarding neural (supraspinal and spinal) and peripheral mechanisms that should be more thoroughly examined in children.

CONCLUSION

Suitable methods, such as transcranial magnetic stimulation, transcranial electrical stimulation, functional magnetic resonance imaging, near-infrared spectroscopy, tendon vibration, H-reflex, and ultrasound are recommended in the research field of fatigue in youth. By designing studies that test the fatigue effects in movements that replicate daily activities, new knowledge will be acquired. The linkage and interaction between physiological, cognitive, and psychological aspects of human performance remain to be resolved in young people. This can only be successful if research is based on a foundation of basic research focused on the mechanisms of fatigue while measuring all three above aspects.

Variations in Hypoxia Impairs Muscle Oxygenation and Performance during Simulated Team-Sport Running

Purpose: To quantify the effect of acute hypoxia on muscle oxygenation and power during simulated team-sport running. Methods: Seven individuals performed repeated and single sprint efforts, embedded in a simulated team-sport running protocol, on a non-motorized treadmill in normoxia (sea-level), and acute normobaric hypoxia (simulated altitudes of 2,000 and 3,000 m). Mean and peak power was quantified during all sprints and repeated sprints. Mean total work, heart rate, blood oxygen saturation, and quadriceps muscle deoxyhaemoglobin concentration (assessed via near-infrared spectroscopy) were measured over the entire protocol. A linear mixed model was used to estimate performance and physiological effects across each half of the protocol. Changes were expressed in standardized units for assessment of magnitude. Uncertainty in the changes was expressed as a 90% confidence interval and interpreted via non-clinical magnitude-based inference. Results: Mean total work was reduced at 2,000 m (-10%, 90% confidence limits ±6%) and 3,000 m (-15%, ±5%) compared with sea-level. Mean heart rate was reduced at 3,000 m compared with 2,000 m (-3, ±3 min^-1) and sea-level (-3, ±3 min^-1). Blood oxygen saturation was lower at 2,000 m (-8, ±3%) and 3,000 m (-15, ±2%) compared with sea-level. Sprint mean power across the entire protocol was reduced at 3,000 m compared with 2,000 m (-12%, ±3%) and sea-level (-14%, ±4%). In the second half of the protocol, sprint mean power was reduced at 3,000 m compared to 2,000 m (-6%, ±4%). Sprint mean peak power across the entire protocol was lowered at 2,000 m (-10%, ±6%) and 3,000 m (-16%, ±6%) compared with sea-level. During repeated sprints, mean peak power was lower at 2,000 m (-8%, ±7%) and 3,000 m (-8%, ±7%) compared with sea-level. In the second half of the protocol, repeated sprint mean power was reduced at 3,000 m compared to 2,000 m (-7%, ±5%) and sea-level (-9%, ±5%). Quadriceps muscle deoxyhaemoglobin concentration was lowered at 3,000 m compared to 2,000 m (-10, ±12%) and sea-level (-11, ±12%). Conclusions: Simulated team-sport running is impaired at 3,000 m compared to 2,000 m and sea-level, likely due to a higher muscle deoxygenation.

Ensemble Input of Group III/IV Muscle Afferents to CNS: A Limiting Factor of Central Motor Drive During Endurance Exercise from Normoxia to Moderate Hypoxia

We recently hypothesized that across the range of normoxia to severe hypoxia the major determinant of central motor drive (CMD) during endurance exercise switches from a predominantly peripheral origin to a hypoxic-sensitive central component of fatigue. We found that peripheral locomotor muscle fatigue (pLMF) is the prevailing factor limiting central motor drive and therefore exercise performance from normoxia to moderate hypoxia (SaO2 > 75 %). In these levels of arterial hypoxemia, the development of pLMF is confined to a certain limit which varies between humans-pLMF does not develop to this limit in more severe hypoxia (SaO2 < 70 %) and exercise is prematurely terminated presumably to protect the brain from insufficient O2 supply. Based on the observations from normoxia to moderate hypoxia, we outlined a model suggesting that group III/IV muscle afferents impose inhibitory influences on the determination of CMD of working humans during high-intensity endurance exercise with the purpose to regulate and restrict the level of exercise-induced pLMF to an "individual critical threshold." To experimentally test this model, we pharmacologically blocked somatosensory pathways originating in the working limbs during cycling exercise in normoxia. After initial difficulties with a local anesthetic (epidural lidocaine, L3-L4) and associated loss of locomotor muscle strength we switched to an intrathecally applied opioid analgesic (fentanyl, L3-L4). These experiments were the first ever to selectively block locomotor muscle afferents during high-intensity cycling exercise without affecting maximal locomotor muscle strength. In the absence of opioid-mediated neural feedback from the working limbs, CMD was increased and end-exercise pLMF substantially exceeded, for the first time, the individual critical threshold of peripheral fatigue. The outcome of these studies confirm our hypothesis claiming that afferent feedback inhibits CMD and restricts the development of pLMF to an individual critical threshold as observed from normoxia up to moderate hypoxia.

Ammonia metabolism, the brain and fatigue; revisiting the link

This review addresses the ammonia fatigue theory in light of new evidence from exercise and disease studies and aims to provide a view of the role of ammonia during exercise. Hyperammonemia is a condition common to pathological liver disorders and intense or exhausting exercise. In pathology, hyperammonemia is linked to impairment of normal brain function and the onset of the neurological condition, hepatic encephalopathy. Elevated blood ammonia concentrations arise due to a diminished capacity for removal via the liver and lead to increased exposure of organs, such as the brain, to the toxic effects of ammonia. High levels of brain ammonia can lead to deleterious alterations in astrocyte morphology, cerebral energy metabolism and neurotransmission, which may in turn impact on the functioning of important signalling pathways within the neuron. Such changes are believed to contribute to the disturbances in neuropsychological function, in particular the learning, memory, and motor control deficits observed in animal models of liver disease and also patients with cirrhosis. Hyperammonemia in exercise occurs as a result of an increased production by contracting muscle, through adenosine monophosphate (AMP) deamination (the purine nucleotide cycle) and branched chain amino acid (BCAA) deamination prior to oxidation. Plasma concentrations of ammonia during exercise often achieve or exceed those measured in liver disease patients, resulting in increased cerebral uptake. In this article we propose that exercise-induced hyperammonemia may lead to concomitant disturbances in brain function, potentially through similar mechanisms underpinning pathology, which may impact on performance as fatigue or reduced function, especially during extreme exercise.

Nervous system function during exercise in hypoxia

Aerobic exercise capacity decreases with exposure to hypoxia. This article focuses on the effects of hypoxia on nervous system function and the potential consequences for the exercising human. Emphasis is put on somatosensory muscle afferents due to their crucial role in the reflex inhibition of muscle activation and in cardiorespiratory reflex control during exercise. We review the evidence of hypoxia influences on muscle afferents and discuss important consequences for exercise performance. Efferent (motor) nerves are less affected at altitude and are thought to stay fairly functional even in severe levels of arterial hypoxemia. Altitude also alters autonomic nervous system functions, which are thought to play an important role in the regulation of cardiac output and ventilation. Finally, the consequences of hypoxia-induced cortical adaptations and dysfunctions are evaluated in terms of neurotransmitter turnover, brain electrical activity, and cortical excitability. Even though the cessation of exercise or the reduction of exercise intensity, when reaching maximum performance, implies reduced motor recruitment by the nervous system, the mechanisms that lead to the de-recruitment of active muscle are still not well understood. In moderate hypoxia, muscle afferents appear to play an important role, whereas in severe hypoxia brain oxygenation may play a more important role.